Medical instrument and medical instrument manufacture

Abstract

A medical instrument (30, 230) has a shaft (34) extending between a distal end (38) and a proximal end (40). A housing (36) is provided at the proximal end (40) of the shaft (34). At least one effector (60) is provided at the distal end (38) of the shaft (34). The instrument (30, 230) has at least one control element (72) for mechanically controlling the effector (60). The control element (72) extends at least in portions through a guide tube (70) extending parallel to the shaft (34). The guide tube (70) is provided at least in portions along its longitudinal extent (104) with lateral cutouts (100), through which the guide tube (70) is accessible for cleaning media. A method is used for manufacturing a guide tube (70) of a medical instrument (30, 230).

What is claimed is: 
     
         1 . A medical instrument comprising:
 a shaft extending between a distal end and a proximal end;   a housing at the proximal end of the shaft;   at least one effector at the distal end of the shaft;   at least one control element for mechanically controlling the effector; and   a guide tube extending parallel to the shaft, wherein the control element extends at least in portions through the guide tube and wherein the guide tube is provided at least in portions, along a guide tube longitudinal extent, with lateral cutouts, through which the guide tube is accessible for cleaning media.   
     
     
         2 . A medical instrument according to  claim 1 , wherein the effector comprises a deflectable lever at the distal end of the shaft. 
     
     
         3 . A medical instrument according to  claim 1 , further comprising an actuating element for actuating the effector, wherein the actuating element is formed on the housing and the actuating element is configured to move the control element distally or proximally. 
     
     
         4 . A medical instrument according to  claim 1 , wherein the guide tube is fastened to the shaft in a first circumferential portion, and wherein the cutouts are formed on a second circumferential portion of the guide tube facing away from the first circumferential portion. 
     
     
         5 . A medical instrument according to  claim 1 , wherein the lateral cutouts comprise multiple cutouts forming a row along the guide tube longitudinal extent. 
     
     
         6 . A medical instrument according to  claim 1 , wherein the lateral cutouts are configured as elongated holes or ellipses and have a longitudinal extent and a transverse extent, and wherein the longitudinal extent is at least twice the transverse extent. 
     
     
         7 . A medical instrument according to  claim 1 ,
 wherein the lateral cutouts have a longitudinal extent which is between 10 mm and 30 mm, and/or   wherein the cutouts have a transverse extent which is between 0.15 mm and 1.0 mm.   
     
     
         8 . A medical instrument according to  claim 1 ,
 wherein the guide tube has an outer diameter which is less than 2.2 mm, and/or   wherein the guide tube has a wall thickness which is less than 0.3 mm.   
     
     
         9 . A medical instrument according to  claim 1 , wherein the cutouts are cut out with little or no post-processing by means of ultrashort pulse laser processing. 
     
     
         10 . A medical instrument according to  claim 1 , wherein edges of the lateral cutouts are configured to be low in burrs or burr-free. 
     
     
         11 . A medical instrument according to  claim 1 , wherein the lateral cutouts have side walls, wherein opposing side walls of a cutout enclose an outward-opening angle that is greater than 5°, and wherein the side walls are oriented radially to a longitudinal axis of the guide tube. 
     
     
         12 . A medical instrument according to  claim 1 , further comprising:
 a second guide tube; and   a second control element, wherein the guide tube extending parallel to the shaft is a first guide tube and the at least one control element for mechanically controlling the effector is a first control element, wherein the first guide tube and the second guide tube are arranged on the shaft as guide tubes fastened to the outside of the shaft, wherein the first guide tube accommodates the first control element and the second guide tube accommodates the second control element, and wherein the first control element and the second control element are coupled to the effector at the distal end.   
     
     
         13 . A medical instrument according to  claim 1 , wherein the shaft is connected to the housing and opens into the housing, wherein the housing provides proximal access into the shaft, and wherein at least the shaft or the housing comprises at least one bore which is inclined relative to a shaft axis of the shaft and through which a housing chamber used by the controller of the effector is accessible for cleaning media. 
     
     
         14 . A medical instrument according to  claim 13 , wherein the guide tube and the shaft are fluidically connected to each other via the housing chamber. 
     
     
         15 . A medical instrument according to  claim 13 , wherein the guide tube opens into the housing chamber. 
     
     
         16 . A medical instrument according to  claim 13 , wherein the at least one inclined bore is formed as a transverse bore through the shaft to the housing chamber, as a transverse bore oriented orthogonally to the longitudinal axis of the shaft. 
     
     
         17 . A medical instrument according to  claim 13 , wherein the at least one inclined bore is formed as a connecting bore between a housing part at the proximal end of the shaft and the housing chamber, at an acute angle to the longitudinal axis, which angle opens distally. 
     
     
         18 . A medical instrument according to  claim 1 , further comprising a rod, wherein the control element is coupled at a control element proximal end to the rod and the rod extends through a wall piece into the housing, and wherein a guide tube proximal end is spaced apart from the housing. 
     
     
         19 . A method for manufacturing a guide tube of a medical instrument comprising a shaft extending between a distal end and a proximal end, a housing at the proximal end of the shaft, at least one effector at the distal end of the shaft, at least one control element for mechanically controlling the effector, and a guide tube extending parallel to the shaft, wherein the control element extends at least in portions through the guide and wherein the guide tube is provided at least in portions, along a guide tube longitudinal extent, with lateral cutouts, through which the guide tube is accessible for cleaning media, the method comprising the steps of:
 providing a workpiece in a form of a semi-finished product having a thin-walled tubular body with a longitudinal axis extending between a first end and a second end;   providing an ultrashort pulse laser;   clamping the workpiece in a workpiece holder;   operating the ultrashort pulse laser to process the workpiece by sublimation;   creating a plurality of cutouts in the workpiece comprising:
 generating a coordinated relative movement between the tubular body and the ultrashort pulse laser with the ultrashort pulse laser activated, comprising a translational movement along the longitudinal axis and a pivoting movement with respect to the longitudinal axis to create a cut-out section in the workpiece, which cut-out section defines each cutout, and 
 generating a feed movement between the tubular body and the ultrashort pulse laser with the ultrashort pulse laser deactivated, comprising a translational movement along the longitudinal axis to create the lateral cutouts that are spaced apart from one another. 
   
     
     
         20 . A method according to  claim 19 , further comprising the step of:
 removing the cut-out sections radially outward, wherein the cut-out sections have mutually inclined and opposite side walls, the angle of inclination of which points in the direction of the longitudinal axis, and/or   rotating the workpiece about the longitudinal axis until the cut-out sections can be removed with the assistance of gravity.